Timely, accurate diagnosis is key to effective biliary cancer treatment. Our diagnostic team includes pathologists, radiologists, gastroenterologists, and surgeons with extensive experience in confirming this diagnosis with the latest technology.
Beginning with your first appointment at the Pancreas and Biliary Tumor Center at Dana-Farber Brigham Cancer Center, our specialists care for you and manage your diagnosis as a team. We make every effort to coordinate your testing and care.
- Concentrated expertise: Our surgical, radiology and pathology teams specialize in cancer imaging and diagnostics. This means that we have in-depth experience with this disease process.
- Radiologists and pathologists at the Center specialize specifically in gastrointestinal and pancreaticobiliary malignancies.
Rapid Response
We know the importance of making an early diagnosis, and we efficiently move you through the testing process. If a diagnosis of biliary cancer is determined, your clinical team will work with you to create and oversee a personalized treatment plan.
Diagnostic Testing
Team Approach
Before treatment can begin, you will have a diagnostic workup by a team that includes a gastroenterologist, pathologist, radiologist, and surgeon — all of whom specialize in the biliary tract. This process ensures that your care is carefully coordinated to save time and achieve optimal results.
Your tests are conducted and reviewed by the doctors whom you see during appointments, as well as their colleagues at our Center, who meet to review your test results together.
Diagnostic tests and procedures that produce images of the biliary tree and the surrounding area are used to detect, diagnose, and stage biliary cancer. Upon diagnosis, our entire specialty team meets to determine the optimal treatment plan for you.
Diagnostic tests and procedures that produce images of the biliary tree and the surrounding area are used to detect, diagnose, and stage biliary cancer. Upon diagnosis, our entire specialty team meets to determine the optimal treatment plan for you.
Endoscopy
We use advanced endoscopic techniques to evaluate tumors and to relieve any obstruction of the bile duct through stenting, including:
- Endoscopic ultrasound (EUS): A procedure used to look through the wall of the nearby stomach and intestine. An endoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted into the body, usually through the mouth, to form a picture of body tissues and check for signs of cancer. This gives us the highest resolution imaging available and guides whether — and how — we conduct a biopsy. The most common diagnostic study for gallstone-related disease is ultrasound.
- Endomicroscopy: A procedure that takes images from inside the body in real-time through a highly specialized probe. This can be a powerful tool that can help us better target the biopsies.
- Endoscopic retrograde cholangiopancreatography (ERCP): A procedure used to x-ray the ducts (tubes) that carry bile from the liver to the gallbladder and from the gallbladder to the small intestine. An endoscope (a thin, lighted tube) is passed through the mouth, esophagus, and stomach into the first part of the small intestine. A catheter (a smaller tube) is then inserted through the endoscope into the biliary ducts. A dye is injected through the catheter into the ducts, and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted relieve the block in the duct. The tube (or stent) may be left in place to keep the duct open. Samples may also be taken.
Our Advanced Endoscopy Research
Learn more about advanced endoscopic research at Brigham and Women’s Hospital that has led to new techniques and devices.
Gastroenterology
A gastroenterologist is often the first physician you see for the initial diagnosis. We use advanced endoscopic techniques, including evaluation of tumors with endoscopic ultrasound, to conduct biopsies and make a diagnosis. You will also see a gastroenterologist if you develop a complication such as a blocked bile duct that should be cleared in order for you to start or continue treatment.
- Biliary cancer can sometimes lead to blockages in the bile duct. In the initial diagnosis, you will be evaluated for this.
- We use tiny scopes (endoscopes) to see if there is a blockage that we can open with dilation.
- You may have a stent placed to allow bile to drain.
It is important to relieve these blockages because if bile is backed up, it can cause discomfort and prevent doctors from being able to administer chemotherapy.
Gastroenterology at Our Center
Gastroenterology at the Pancreas and Biliary Tumor Center includes physicians who manage biliary diseases and physicians who perform complex endoscopic procedures to diagnose and manage problems. We also have gastroenterologists who focus on patients who are at high risk for developing biliary cancer.
If you have a family history of gastrointestinal cancer, you can meet with our genetic counselors for an in-depth risk assessment, including:
- A detailed family history analysis
- Genetic evaluation through state-of-the-art molecular tests
- Tailored cancer screening and prevention recommendations